Hydrolysed casein formula may slash eczema in infants
development of eczema by 33 per cent, says a three-year study from
Germany.
"The 3-year results of this large-scale, prospective, randomized, double-blind trial clearly confirm the concept that the risk for [ atopic dermatitis ] AD but not for early asthma can be reduced by nutritional intervention in infants at high risk for allergic diseases," wrote lead author Andrea Von Berg in the Journal of Allergy and Clinical Immunology .
"The strength of the preventive effect seems to depend on the type of formula used as well as on the compliance with the feeding recommendations in the first 4 months of life."
Eczema, also known as atopic dermatitis (AD), is one of the first signs of allergy during the early days of life and is said to be due to delayed development of the immune system.
According to the American Academy of Dermatologists it affects between 10 to 20 percent of all infants, but almost half of these kids will 'grow out' of eczema between the ages of five and 15.
The researchers, from Marien-Hospital Wesel, Ludwig Maximilians University, Neuherberg's Institute of Epidemiology, and Technical University of Munich, recruited 2252 newborns with a family history of allergy and assigned them to one of four intervention groups: formula containing only cow's milk (control), or formulas with partially hydrolyzed whey, extensively hydrolyzed whey, or extensively hydrolyzed casein.
Cow's milk proteins, which are the most widely used in routine infant formulas, are the most common allergen in infancy, so the study examined formulas in which the proteins were broken down to decrease the chances of allergy.
The German Infant Nutritional Intervention Study (GINI) found that after three years, the partially hydrolyzed whey formula and the extensively hydrolyzed casein formula reduced the period prevalence of eczema by 48 and 47 per cent, respectively, while the cumulative incidence for the extensively hydrolyzed casein formula decreased by 33 per cent, compared to the cow's milk formula group.
"The preventive effect developed in the first year and persisted into the third year, indicating real disease reduction rather than postponement of disease onset," wrote Von Berg.
The researchers also report that children with a genetic history of eczema in their family had a significantly reduced risk of eczema when consuming only the extensively hydrolyzed casein formula.
"This is indeed the first study to suggest that the allergic phenotype in the family rather than a biparental family history modifies the effect of nutritional intervention and may be considered when deciding which hydrolysate should be given," they said.
Infant formula is a highly emotive area, with watchdogs keeping a close eye on companies' marketing tactics lest they drift towards promoting their products as preferable to breast-feeding.
While it is agreed that breastfeeding is the best way to ensure an infant receives the nutrients it needs in its first months, formulas are indispensable in cases where mothers are unable to feed their children - be it for health or logistical reasons.
Mothers' desire to give their children the best possible start in life means that there is scope for fortification.
Indeed, van Berg and her colleagues state: " It was… not the goal of our study to question this gold standard and show that hydrolysates are worse or better.
Instead, we wanted to evaluate, in case of formula feeding (for whatever reason), which formula would be the best alternative to reduce the risk for allergic manifestations."
The latest market research on the overall baby food market, including milks and formulas, comes from Mintel, which estimates that the UK market was worth £329 million at retail in 2005.
Source: Journal of Allergy and Clinical Immunology Published on-line ahead of print, doi: 10.1016/j.jaci.2006.11.017 "Certain hydrolyzed formulas reduce the incidence of atopic dermatitis but not that of asthma:
Three-year results of the German Infant Nutritional Intervention Study" Authors: A. von Berg, S. Koletzko, B. Filipiak-Pittroff, B. Laubereau, A. Grübl, H.-E. Wichmann, C.-P. Bauer, D. Reinhardt, D. Berdel and the German Infant Nutritional Intervention Study Group
